Urolift treatment for the enlarged prostate

About the procedure

What does the procedure involve?

This minimally-invasive treatment system opens the blocked urethra by lifting or holding prostate tissue out of the way by placing implants to pull open the prostatic cavity.

What are the alternatives to this procedure?

Use of a catheter, monitoring of symptoms, lifestyle advice, medication, rezum water vapour therapy, surgery to open the prostatic channel (by, for example, transurethral resection of the prostate [TURP] or laser surgery), open prostatic surgery.

What should I expect before the procedure?

You will usually be admitted on the same day as your surgery. You may receive an appointment for pre-assessment, to assess your general fitness and to perform some initial investigations. After admission, you will be seen by members of the medical team which will include the consultant, the anaesthetist and your named nurse.

You will be asked not to eat or drink for six hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy.

Please be sure to inform your urologist in advance of your surgery if you have any of the following:

• an artificial heart valve
• a coronary artery stent
• a heart pacemaker or defibrillator
• an artificial joint
• an artificial blood vessel graft
• a neurosurgical shunt
• any other implanted foreign body
• a prescription for warfarin, aspirin or clopidogrel (Plavix®)
• a previous or current MRSA infection
• high risk of variant CJD (if you have received a corneal transplant, a neurosurgical dural transplant or previous injections of human-derived growth hormone)

What happens during the procedure?

A fine telescope-like instrument is inserted into your urethra. This device enables the surgeon to deploy a small implant between the inner and outer surfaces of the prostate, rather like a small treasury tag. This implant retracts the enlarged prostate lobe without the need for any cutting. The number of implants required varies according to the size and shape of the prostate, and usually between two and four implants need to be deployed. After the implants have been placed, most patients will be able to pass urine without the need for a catheter.

The operation is usually performed under sedation or under a general anaesthetic, which means you will be asleep for the entire procedure. Typically, you will go home on the same day as the surgery. You will need someone to take you home after surgery.

What happens immediately after the procedure?

During the three to five days after your procedure, you may have some blood in your urine, and it may sting when you pass water. This is normal, and should clear after a few days. Sensitivity in the penis due to the operation can last a few weeks, and usually settles after healing is complete.

If you have some discomfort following the operation or from the catheter, over-the-counter pain killers like paracetamol are generally quite sufficient. You may be prescribed antibiotics to prevent urinary infection.

Are there any side effects?

Most procedures have a potential for side effects. You should be reassured that, although all these complications are well-recognised, the majority of patients do not suffer any problems after a urological procedure.

Please use the check boxes below to tick off individual items when you are happy that they have been discussed to your satisfaction:

Common (greater than 1 in 10)

☐ Frequency and urgency to pass urine (usually temporary with resolution usually in days).
☐ Blood in the urine (usually temporary with resolution usually in days).

Occasional (between 1 in 10 and 1 in 50)

☐ Temporary pelvic discomfort or pain.
☐ Urinary tract infection.
☐ Prolonged retention.
☐ Continuing enlargement of the prostate and need for further prostate surgery.
☐ Failure to resolve symptoms (due to continuing blockage or a bladder problem).

Rare (less than 1 in 50)

☐ Encrustation of the implant; this may require further surgery to remove the implant using a cystoscope (a telescope through the penis).

What should I expect when I get home?

When you leave hospital, you will be given a 'draft' discharge summary of your admission. This holds important information about your inpatient stay and your operation.

• You can safely undertake light exercise after the operation, but you must avoid heavy lifting, straining, long journeys and sexual activity in the first month.
• You should maintain a good fluid intake of 1.5 to 2 litres a day, drink steadily throughout the day, and avoid taking too much tea, coffee, fizzy drinks and alcohol as these may irritate your bladder.
• You should pass urine according to how you feel the need to do so. You may need to have up to two weeks off work, although the average return to normal activity is five days.

It is sensible to avoid driving in this period. It is common to have less control passing urine for a short time after surgery.

What else should I look out for?

After you have had prostate surgery, contact your GP (general practitioner) or the ward if you have any problems such as pain, bleeding or symptoms of urinary infection or feeling generally unwell. If severe, please go to your nearest Accident and Emergency Department.

Privacy and dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and / or specialist one-to-one care is required.